Individual
HOLLY DIEDRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24 PUBLIC SCHOOL RD, TIJERAS, NM 87059-8600
(505) 281-0880
Mailing address
PO BOX 25704, ALBUQUERQUE, NM 87125-0704
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
57947
NM
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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